Von Eschenbach Takes Over at FDA

National Cancer Institute (NCI) director Andrew von Eschenbach was appointed acting head of the U.S. Food and Drug Administration late Friday after FDA's embattled chief abruptly resigned. To the dismay of some cancer specialists and FDA watchers, von Eschenbach plans to head both organizations simultaneously. That's prompting charges of conflict of interest, along with worries that no appointee can successfully juggle these two very demanding jobs.

Already buffeted by controversies ranging from Vioxx to the morning-after pill Plan B, FDA lost its leader Friday when Lester Crawford, a 67-year-old veterinary specialist and pharmacologist, suddenly quit. Crawford did not give a reason for his departure. He was confirmed just two months ago by Congress.

Von Eschenbach is a urologic surgeon who came to NCI in 2002 from the University of Texas MD Anderson Cancer Center in Houston. He has stirred controversy by vowing to eliminate suffering and death from cancer by 2015, a goal many cancer researchers feel is unrealistic. His push for more translational research has included a partnership with NCI and FDA to speed the approval of cancer drugs.

Trade groups welcomed the appointment. In a statement, former congressman James Greenwood, president of the Biotechnology Industry Organization, praised von Eschenbach's "unique insights into the critical need to advance new treatments" and called the appointment "an excellent choice." The Pharmaceutical Research and Manufacturers of America (PhRMA) also issued a statement of support.

But several scientists and physicians have expressed concern. "To me, it's a little bit disconcerting," says David Johnson, who served on FDA's oncology drugs advisory committee and is deputy director of the Vanderbilt-Ingram Cancer Center in Nashville, Tennessee. "There's a possibility of a conflict of interest," he notes, because FDA routinely considers drugs and trials developed by scientists at NCI.

Another worry is whether one leader, no matter how skilled a multitasker, will be able to give both organizations the attention needed. "Long-term I wonder whether it serves the best interests of all the constituencies," says Michael Friedman, the president and CEO of City of Hope, a cancer hospital in Duarte, California, and a former acting commissioner of FDA. Still, Friedman is less concerned about a conflict of interest, noting that von Eschenbach could delegate NCI-related decisions to others at FDA.

Neither von Eschenbach nor the White House, which made the appointment, has commented on how long he might hold both positions. FDA spokesperson Julie Zawisza said von Eschenbach was not available for interviews before ScienceNOW's deadline, but she said FDA is "looking very carefully" at possible conflicts of interest with cancer drugs. "That will all be sorted out with legal minds," she said.